A rare cause of spontaneous spleen rupture in a chronic hemodialysis patient: littoral cell angioma
38th European Congress of Pathology, Stockholm, İsveç, 12 - 16 Eylül 2026, cilt.489, ss.405, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Cilt numarası: 489
- Basıldığı Şehir: Stockholm
- Basıldığı Ülke: İsveç
- Sayfa Sayıları: ss.405
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
Background & Objectives: Littoral cell angioma (LCA) is a primary vascular endothelial tumour originating from littoral cells of the spleen. LCA is generally benign, but rare malignant cases have also been reported, first described by Falk in 1991. In this article, we present a case of a chronic haemodialysis (HD) patient who developed spontaneous splenic rupture and was diagnosed with LCA from splenectomy material. Methods: A 59-year-old male patient with renal failure for 5 years and receiving HD treatment presented to our hospital with complaints of abdominal pain and high fever. He was found to have acute phase elevation and erythropoietinresistant anaemia, accompanied by nausea, vomiting, hypotension, and decreased haematocrit. An abdominal CT scan revealed a splenic hematoma/rupture. The patient underwent emergency splenectomy. Macroscopic examination of the splenectomy specimen showed compromised capsule integrity and haemorrhage. Histopathological examination revealed a lesion consisting of numerous anastomosing vascular structures. The cells lining these vascular spaces were generally long, cylindrical, or cuboidal in shape. Hemosiderin (iron pigment) granules were frequently observed in the cytoplasm of the cells. Cells forming papillary projections in the vascular areas were noteworthy. Immunohistochemical analysis revealed CD68 (+), CD31 (+), and CD34 (-) in the neoplastic cells. Based on the morphological and immunohistochemical findings, the case was reported as Littoral Cell Angioma. Results: LCA is generally asymptomatic and is diagnosed incidentally. In symptomatic cases, abdominal pain, anaemia, thrombocytopenia, and splenomegaly are usually observed. Diagnosis is quite difficult with clinical, laboratory, and imaging methods. Definitive diagnosis is made by histopathological examination of the spleen. Although LCA is generally benign, it can rarely be malignant. Conclusion: LCA should be considered in chronic HD patients with persistent abdominal pain, fever, hepatosplenomegaly, acute phase elevation, and erythropoietinresistant anaemia. LCA can cause spontaneous splenic rupture. Although this mostly benign tumour is difficult to diagnose, patient survival after splenectomy is encouraging.